This K01 Mentored Research Scientist Development Award requests funding to support education activities and research investigation focused on service use, cost-effectiveness and health outcomes of a community-based program that delivers care to impoverished urban elders. The Neighborhood Outreach Project (NOP) is a multidisciplinary team initiative that delivers services (blood pressure and blood glucose screening, health education, medication monitoring, etc.) to elders who mostly are over 70 years of age, female, black, and impoverished and live in public housing facilities. Specifically, the specific aims of this proposed investigation and various learning activities in support of it are: 1) to determine the longitudinal changes in health service use of participants in the NOP compared t a control group; 2) to examine the differences in health outcomes of NOP participants compared to a control group; and 3) to determine the cost-effectiveness of the NOP compared to a control group receiving no services from NOP. Training activities will compliment to research objectives by providing mentoring and consultation regarding: 1) development of a culturally, age appropriate quality of life instrument as one outcome measure; 2) development of a model to measure cost-effectiveness; 3) gain expertise in secondary analysis through utilization of HCFA files; and 4) become expert in longitudinal statistical analyses. A minimum of one hundred and fifty subjects will be randomly selected from the NOP participants and one hundred and fifty subjects will be randomly selected from three other public housing sites with similar demographic characteristics. The basic premise of this study is to examine how community based projects improve health outcomes, provide health services at a reduced costs, and decrease inappropriate health service use. In developing a program of research focusing on outcomes and health services utilization, the investigator is interested in determining the differences in outcomes, services use and cost in various service delivery models such as primary care and case management in the future.